Following is a question by the Professor Hon Joseph Lee and a written reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 28):

Question:

     Earlier, a woman who had a miscarriage before 24 weeks of pregnancy sought my assistance, saying that only after a lot of twists and turns was she allowed to collect the stillbirth from the public hospital concerned.  Moreover, as the hospital had refused to issue the Certificate of Stillbirth (the Certificate), she was unable to arrange for cremation and burial of the stillbirth.  She was infuriated by the hospital's suggestion that she arrange for cremation of the stillbirth as a pet.  It is learnt that the Hospital Authority (HA) currently treats stillbirths of less than 24 weeks as clinical waste and will not issue the Certificate for such stillbirths.  In this connection, will the Government inform this Council if it knows:

(1) the number of cases of miscarriage before 24 weeks of pregnancy throughout the territory in the past five years; among such cases, the number of those in which the parents of the stillbirths were allowed to collect the stillbirths, and the burial arrangements for the stillbirths collected;

(2) the justification for HA's decision to treat stillbirths of less than 24 weeks as clinical waste; whether the authorities will review the relevant arrangement to make it more respectful of the feelings of parents of stillbirths; if so, of the details; if not, the reasons for that; and

(3) whether there is legal basis for HA's doctors to refuse to issue the Certificate in respect of stillbirths of less than 24 weeks; if so, of the details; whether HA will change such practice to address the aspirations of some parents of stillbirths; if HA will, of the details; if not, the reasons for that?

Reply:

President,

     My reply to the various parts of the question raised by the Professor Hon Joseph Lee is as follows:

(1) The Department of Health and the Hospital Authority (HA) do not maintain statistical record on the number of cases of miscarriage before the 24th week of pregnancy.  As for the number of abortuses with less than 24 weeks of gestation collected upon HA's approval, HA has only kept the relevant figures from 2015 onwards, which are tabulated below:

Year	Number of abortuses with less than 24 weeks of gestation collected upon HA’s approval
2015	2
2016	8
2017 (as at June 15)	13
Total	23

     According to the information provided by the claimants to HA, among the 23 cases, 15 involved burial in private cemeteries, while the remaining eight involved cremation by private facilities.

(2) and (3)  The definition of "stillbirth" is based on the consensus of the medical profession on the gestational age and birth weight at which a baby is viable at birth.  In Hong Kong, the medical profession has defined "stillbirth" as a baby born without sign of life, at or after 24 weeks of gestation, or with a birth weight of more than 500 grams when the gestational age is uncertain.  This definition is contained in the guidelines issued by the Hong Kong College of Obstetricians and Gynaecologists (HKCOG).  The same definition has been adopted by other countries.  Under section 18 of the Births and Deaths Registration Ordinance (Cap. 174), doctors may issue a Certificate of Still-birth (Form 13 under the Ordinance) in respect of a still-born child.  HA will keep in view the latest developments in the definition in other places and the HKCOG's guideline in order to review whether the definition in Hong Kong needs to be updated.

     As regards abortuses without a Certificate of Still-birth, HA will let the parents concerned claim them back where feasible provided that the relevant legal requirements and such conditions as public health have been met.  Abortuses which have not been claimed will be handled by HA in accordance with the relevant laws.

Ends/Wednesday, June 28, 2017
Issued at HKT 12:57

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